Asadollah Sara, Vahdat Mansoureh, Yazdkhasti Payman, Nikravan Nasrin
Iran University Faculty of Medicine, Rasool-e-Akram Hospital, Clinic of Obstetrics and Gynecology, Tehran, Iran.
Iran University Faculty of Medicine, Rasool-e-Akram Hospital, Clinic of Anesthesiology and Pain, Tehran, Iran.
Turk J Obstet Gynecol. 2015 Mar;12(1):34-37. doi: 10.4274/tjod.02439. Epub 2015 Mar 15.
Recent studies have shown the positive effect of magnesium sulphate (MgSO4) on pain reduction and postoperative analgesic requirements in patients undergoing surgery. We assessed the effect of MgSO4 on intra-operative and postoperative analgesic requirements in patients undergoing lower abdominal gynecological laparotomy.
This randomized clinical trial was conducted on 30 female patients at Rasool-e-Akram (referral and academic) hospital in Tehran from August 2012 to March 2013. The patients who were candidates for gynecologic surgeries (hysterectomy and/or myomectomy) were randomized into study (n=15) and control (n=15) groups. Same anesthetic technique was used in all patients. Besides induction of the anesthesia in the study group, we administered MgSO4 50 mg/kg/hr intravenously (IV) for analgesic purposes as a bolus dose and then 8 mg/kg IV as maintenance dose. Control group received the same anesthetic agents and the same amount of isotonic saline instead of MgSO4. Analgesic consumption was measured in both groups postoperatively within 24 hours. The visual analog scale (VAS) was used for the evaluation of postoperative pain in both groups.
There was a decrease in analgesic consumption and pain in the group receiving MgSO4, in comparison to control group. Pain severity assessment, 24 hours post operatively showed similar results in both groups. There was a statistically significant difference in prescribed dose of pethidine between study and control groups (p=<0.0001).
Intra-operative MgSO4 is effective in postoperative pain control following lower abdominal laparotomy. Further studies with larger sample sizes and longer follow-up should be performed to obtain more information about safety and to determine whether doses of MgSO4 can provide postoperative analgesic benefits.
近期研究表明，硫酸镁（MgSO4）对手术患者的疼痛减轻及术后镇痛需求具有积极作用。我们评估了MgSO4对接受下腹部妇科剖腹手术患者术中及术后镇痛需求的影响。
本随机临床试验于2012年8月至2013年3月在德黑兰拉苏勒 - 阿克拉姆（转诊及学术）医院对30名女性患者进行。符合妇科手术（子宫切除术和/或肌瘤切除术）条件的患者被随机分为研究组（n = 15）和对照组（n = 15）。所有患者均采用相同的麻醉技术。在研究组，除诱导麻醉外，为镇痛目的静脉注射（IV）50 mg/kg/hr的MgSO4作为推注剂量，然后以8 mg/kg IV作为维持剂量。对照组接受相同的麻醉剂及等量的等渗盐水而非MgSO4。术后24小时内测量两组的镇痛药物消耗量。采用视觉模拟量表（VAS）评估两组术后疼痛情况。
与对照组相比，接受MgSO4的组镇痛药物消耗量及疼痛程度有所降低。术后24小时的疼痛严重程度评估显示两组结果相似。研究组和对照组之间哌替啶的处方剂量存在统计学显著差异（p =<0.0001）。
术中使用MgSO4对下腹部剖腹手术后的疼痛控制有效。应进行更大样本量及更长随访时间的进一步研究，以获取更多关于安全性的信息，并确定MgSO4剂量是否能提供术后镇痛益处。
